Bleeding with Concomitant NSAIDs and Anticoagulation: Less Than Expected

Taking nonsteroidal anti-inflammatory agents at baseline or during the study period did not increase risk for bleeding in patients with atrial fibrillation who were on anticoagulation.

As physicians, we are appropriately concerned about the risk for bleeding in patients on both anticoagulation and nonsteroidal anti-inflammatory drugs (NSAIDs). To learn about the risk, researchers performed a post hoc analysis of data from the manufacturer-sponsored randomized ARISTOTLE trial (NEJM JW Cardiol Oct 2011 and N Engl J Med 2011; 365:981), which compared apixaban to warfarin in patients with AF.

Of the 17,423 patients in the current analysis, 832 patients (4.8%) at randomization were on NSAIDs (baseline use), and an additional 2185 (13.2%) reported starting NSAIDs during the median follow-up of 1.8 years (incident use). Nearly one third of patients taking an NSAID also took aspirin or clopidogrel.

Taking NSAIDs at baseline or duri…

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Bleeding with Concomitant NSAIDs and Anticoagulation: Less Than Expected

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Reviewing Author